In this episode Victor shares some important information regarding a growing number of people who are navigating retirement and aging alone. As well as an interview with Steven Senko of Princeton Medical Institute, to raise awareness on their clinical trials.

Make It Last with Victor Medina is hosted by Victor J. Medina, an estate planning and Certified Elder Law Attorney (CELA®) and Certified Financial Planner™ professional (CFP). Through his law firm and independent registered investment advisory company, Victor provides 360º Wealth Protection Strategies for individuals in or nearing retirement.

Victor J. Medina: Hey, everybody. Welcome back to Make it Last. I’m your host, Victor Medina. I’m so glad that you can join us here this Saturday morning where we share with you all of the important information that I think that you ought to know about retirement and navigating you through the financial, legal, and everything like that.

In fact, I’ve got a special guest for you here today. His name is Steven Senko. He’ll be joining us in the second segment. We’re going to talk a little bit about what the Princeton Medical Institute does and how you might get involved, specifically with some of their specific trials to try to help people with certain conditions.

I want to have you join us with that segment and listen in to what Steven has to share with us. Before we get to that, I actually wanted to head into a different topic first.

There’s a growing number of people who are navigating retirement alone. There is a new group that has been formed to help with that. I came across this information recently. There’s a woman named Carol Marak.

She had helped her aging parents for about six years, frequently driving about 125 miles between her home in Dallas, Texas, and their home in West Texas, to shop, to clean, to cook, and do other tasks for them. It reminds me a lot of our guest last week, John Walsh, who was helping us learn a little bit more about when people get older, how to get their things ready to sell, and whatever else.

What it caused Carol, who’s 67, to realize is that there are so many demands that go into giving care to an older person. For Carol, she doesn’t have anybody to do that for her. She was doing it for her parents, but there’s nobody for her.

In February of 2016, she started this thing called the Elder Orphan Facebook Group, which has since grown to about 8,000 members. She works as an editor for a website called seniorcare.com.

It turns out that there are a lot of Americans like Carol who are preparing to age without a spouse or adult children who can help them. We can call them all kinds of things. [laughs] We can call them solo seniors or whatever else, but their ranks are growing.

About 22 percent of the people who are 65 and over are either an elder orphan or at risk of becoming one. Only 12 percent of the women who are aged 80 to 84 were childless, but that number’s going to increase in that same age range in a few years.

This group is actually an exclusive group the way that she runs it. She says that she’s turned down 10,000 requests for an entry. I’m not really sure about that. They have three basic screening questions. Then she looks at their websites.

Look, I think from the position of somebody who’s managing this, this is a very vulnerable population. If you are somebody who is growing old alone, it can be difficult to find your niche and to get comfortable that someone’s going to be able to take care for you as you grow older.

For her, if you want to think about joining the group ‑‑ and I want to talk about something different in a second ‑‑ she requires people to be age 55 and over, unmarried, and without nearby children. Unlike people of the last generation, people in this generation that are growing older, they’re growing older without pensions. If they got an inheritance, many [laughs] times it’s sold already.

Planning for older age is key because, without family members there to help, a crisis can really throw your life upside down. Advanced planning becomes even more critical. Most of the caregiving research that you’ll find online, it seems that you’ll have a family to take care of you, even as a backstop, and not everybody has that.

People who will participate in this Elder Orphan Facebook Group are looking to share sympathy with one another, asking advice about everything from revocable trust to worrying about leaving the working world and what to cook on a weeknight when delivery pizza…that’s it. You don’t want any more of that.

It’s very hard, I think, to find people who can understand what someone who might be in their mid‑60s is facing ‑‑ has never been married, no kids, nephews, or relatives in their life. I guess this is the other component of it. Many people might look at their family or friends that they have found a lot of relief in while they were working as being their family in their senior years.

Those people have their own families that are helping them, so it can be difficult to rely on them. While that can seem depressing and, at times, it is depressing, there’s hope for people that are going down this road. It comes from having to build an infrastructure around yourself to compensate for the fact that you don’t have family.

Your safety net can include both friends and paid professionals. Those paid professionals can, in fact, serve roles of support along the way, whether it’s a financial advisor or lawyer, somebody who is a professional caregiver.

Those people can come together to help you navigate what you’re going to face as you become older and you’re an elder orphan, or you’re a solo senior, or whatever you want to call yourself. There are challenges, for instance, if you face a medical crisis.

I think there’s a survey that was done on this Facebook group that said about 53 percent of these solo seniors have nobody to call if they’re confined to a bed. Another concern is having somebody to drive them around for medical procedures. Again, if you don’t have people that you can call on, you may want to start to rethink your living situation.

People think about changing their living situation as like a physical restraint or constraint issue. It doesn’t always have to be that way. You might think about moving from a three bedroom house in the suburbs to…It doesn’t have to be assisted living. You’re not going to be put out to pasture, but maybe living in an apartment building inside of a town center is a better idea.

In and around our areas, we have these great towns. One of my favorite towns to go and visit is Doylestown, Pennsylvania, because it’s a big walking town, or maybe Lambertville, or New Hope because you can live really central in that area and have all of your services available.

You don’t have to rely on somebody or call on somebody to get things done. These people can be around either to deliver stuff, or you can walk to them, or whatever else.

Then you also want an opportunity to continue to connect with community, whether it’s a weekly worship service, if you’re religious, or volunteering somewhere, finding an activity that you like and you’ll show up at regularly so that people will notice when you’re not there. These are all little tricks that you can use to help you navigate this solo senior lifestyle.

Victor: I’m actually going to take a break here and we’ll welcome Steven, who’s in studio already, to join us with his information about the Princeton Medical Institute.

When we come back in this third segment, I’m going to share with you some additional resources and things to think about if you’re becoming a solo senior and you need help navigating that landscape. Stick with us. We’ll be right back with Steven Senko. This is Make It Last. Be right back.

Victor: Welcome back to Make It Last. I’m joined today by Steven Senko from the Princeton Medical Institute. He’s our guest today, talking a little bit about what they do, their clinical trials, why they need participants. I’m happy to have you, Steven. Thank you for joining us today.

Steven Senko: Thank you, Victor. Appreciate it.

Victor: Talk a little bit about what your role is with Princeton Medical Institute. What do you do for them?

Steven: I’m actually the marketing specialist for Princeton Medical Institute. My job is to try to engage the local communities into our clinical trials and our medical services that we have to offer, whether it be if someone’s interested in a variety of different studies.

For example, we have studies tailoring to memory loss, migraines, cluster headaches, postpartum depression, depression for adults, and depression for adolescents. We just want to make it available to anyone who’s interested.

Victor: What is the Princeton Medical Institute? Where is it located? How long has it been around? What does it do?

Steven: We’re located at 256 Bunn Drive in Princeton, New Jersey. It has been around for about a little more than 20 years or so.

Victor: Where is its main focus? What does it do in terms of these clinical trials? Is that all that it does? What are the areas of the doctors that cover that?

Steven: We have clinical research coordinators that are in charge of the various clinical research studies that we have to offer. We also have board‑certified physicians and psychiatrists at our site as well.

Victor: If you know, about how many clinical trials are going on at a time in these various areas that you’ve outlined ‑‑ postpartum depression, memory loss, so on and so forth ‑‑ how many clinical trials are going on?

Steven: On average, I want to say about a good dozen or so.

Victor: Wow. What is the need for participants? In other words, shouldn’t people be clamoring for this stuff? Do they just not know that it’s around? Where does Princeton Medical Institute have a need in terms of participants for clinical trials?

Steven: For us, it’s important to always have volunteers enroll for clinical studies. Without volunteers, many of the treatments that we would have today technically wouldn’t be available. Because of the importance of clinical research, many view those who volunteer as medical heroes.

Volunteers, they also enable medical professionals to fight against diseases that are huge threats to people all over the world. That’s why there’s always such a huge need for people to enroll in our different studies.

Of course, maybe not a lot of people know that Princeton Medical Institute, that we exist. For my job, I’m just trying to get out there into local communities, whether it be, for example, on radio, on Facebook, Google, or any other different health fair or community outreach initiatives. That’s for my goal for Princeton Medical Institute.

Victor: When you approach these different institutions, entities that are out there, do you find that it’s novel for them to know that it exists and that these clinical trials are available? Are you sharing new information when you’re meeting with them?

Steven: Absolutely, yes. A lot of people that I meet, they don’t even know what a clinical study is. They don’t even know that we exist itself. Maybe I would run into a lot of people who live in the Princeton or the Central Jersey area and, when I mention about our facility and what we have to offer, they’re like, “Oh, I didn’t know you guys were that close.” We’re like, “Yes.”

People, they’re always welcome to come in. We do free medical evaluations and screenings. There’s, of course, no obligation for anyone to actually come in for a study or for a consultation. We just want to make that available for people.

Victor: Listeners in the show know that I’ve got a family member at home that is struggling with a health condition. It’s serious enough that it’s life‑threatening. The concept of clinical trials is something that we’re already on top of.

It seems like some of the areas that you’re in aren’t as life‑threatening. In other words, people might go through life knowing that they’ve got headaches or they’ve got some memory loss and just think, “Well, that’s not clinical trial worthy.”

We’re not talking about cancer. We’re not talking about Parkinson’s. Yet you cover those areas that are a little bit…I don’t want to say less life‑threatening, but still impactful to people. Do you find that people are newly informed about clinical trials that might assist them with some of these…I hate to say lower‑level [laughs] concerns?

These things that doesn’t drive them to know about clinical trials on their own because it’s a life‑threatening condition. Is that new for them to know that they might be able to find help in those areas?

Steven: Yes. Again, like with the different sources that we have to offer, we just want to make it available to people. Also, we want to look over the importance of early detection. It’s never too late, for example, to get one’s memory checked.

For example, if someone either for themself or if they know a friend or a loved one whose memory isn’t as what it used to be and they’re not sure, we just want to make our services available for them to come in for screening.

We can get a baseline to see, “OK, where does one’s memory stand?” From there, we can get a diagnosis and see, according to our medical director or one of our physicians, what is the best steps moving forward.

Victor: Great. If somebody wants to know whether or not there is a clinical trial that’s available for them, what are their first steps in engaging with Princeton Medical Institute or figuring that out?

Steven: For sure, people are always more than welcome to give us a call at one of our numbers. In this case, the 609‑921‑6050 number. We’re also always online at princetonmedicalinstitute.com. In this case, we always have our different studies or our different upcoming events available for anyone.

If anyone is interested in maybe checking us out at a local event ‑‑ for example, a health fair or community outreach initiative ‑‑ we always set up tables and pass out information and recruitment material for anyone who is interested in a particular study. We can give them information in regards to maybe specifically into memory loss, migraines, or depression.

Victor: The list is on the website. If people may not have it on their own, but they go and look at it and they see somebody else might be interested, they can send them to the website, so that people, I hate to say, self‑diagnose, [laughs] but they can try to figure out themselves, “Hey, that’s something that applies to me.”

They can go and investigate whether or not the clinical trial will be available. You mentioned the clinical trials don’t cost anything to anybody. Is that right?

Steven: Nope.

Victor: The idea there is that they be involved on something that might have help for them. In other words, they’d be involved in some form of research that is also treatment related, so that they would have some positive outlook on what that condition is? From that standpoint, [clears throat] they don’t always know whether or not they’re getting the placebo or something else, right? [laughs]

Steven: Of course, yeah.

Victor: They have the opportunity to have some help along the way. How often do the clinical trials change over? If somebody visits there and they see that something is not applicable now, is it something they’re going to look at every couple of months to see whether or not there’s something new? How will they be made available about anything that’s new or coming up on the road?

Steven: For each of our different studies, they’re open depending upon until they close for enrollment. We’re not the only site to do clinical trials. We have other different sites around the country and a few in Russia. It depends upon the timeline and how many people they’re able to fill in a certain study.

Victor: From that period of time, if there’s something new, somebody else is investigating it to some other area, obviously, then they would take something on. They would be up on the website. They’d be able to see that there’s a new area. Is that right?

Steven: Yes.

Victor: OK, great. Listen, this is really important news for people. When we see our seniors, in terms of our audience, people are entering or nearing in retirement. This concept of memory loss, these conditions that do afflict older people, certainly, there is that chance for those people to investigate whether or not a clinical trial is available.

Hey, look, you may not think that your condition is one that merits a clinical trial because it isn’t life‑threatening or isn’t one that we commonly think of in that way, but you might have that opportunity there. You might want to investigate it.

Of course, the Princeton Medical Institute is not only just looking at things that affect seniors. As we were talking about before, we got people that are postpartum depression, things in adolescence.

If it’s not you, maybe it’s your child. Maybe it’s your grandchild. Maybe there is something that’s afflicting them that being involved in a clinical trial might actually help them. It’s worthwhile checking that out.

I want to thank Steven for being our guest here today. He’s working with the Princeton Medical Institute. You can figure out more information. Give us those numbers again, the phone number and the website, Steven.

Steven: Yes, of course.

Victor: Where can people find them?

Steven: The best phone number for anyone to reach us would be the 609‑921‑6050, or check us out at www.princetonmedicalinstitute.com.

Steven: Once you’re on that web page, you would see on the home page the Join a Research Study page. You would click on that, and you would see all the different studies that we have available.

Victor: That’s great. Thank you so much for joining us today.

Steven: Thank you.

Victor: All right. We’ll be right back on Make It Last where I’ll share with you some more important information about navigating retirement alone. Stick with us. We’ll be right back.

Victor: Welcome back to Make It Last. When we started the show, I was starting to share some information with you about aging solo, growing older, retirement, and how to deal with that. Before we end it for today, I want to share with you a few more pieces of information because I think this topic is really important.

If you can identify a solo senior in your life or somebody who’s an elder orphan, I want you to be able to help them. Maybe this is you. Maybe this is somebody that you know.

We first started talking about setting up your life in a way that helps support growing older alone ‑‑ changing your living situation or building a community so that people know if you’re missing or [laughs] something’s wrong with you, having a regular interaction with the world. On the more formal side of things, you want to reexamine a little bit on your legal planning.

For instance, one of the more important documents to make sure that you get right is going to be your healthcare proxy. Now remember, that’s the document that helps determine who can make health decisions for you if you can’t make it on your own. For people with families, sometimes it’s very natural to have a child or a spouse there to help them make decisions.

If you don’t have that person there, then we want to make sure that you’ve outlined in a living will what kind of medical interventions you might want or the ones that you might reject, including things like, “Do you want help with breathing if you can’t breathe on your own?” You’re going to want to look at that form and make sure that you have named somebody to be in that role.

Just as important as putting that document in place, it’s just as important to realize that that can change over time. If you’re relying on a non‑family relationship, you’re going to want to be reviewing your relationship with that individual because that might change and morph over time. Somebody who’s very close to you now may not be somebody that’s close to you in the future.

If you just name somebody and then set and forget your legal documents, then you may not have the opportunity to have the right person making those decisions. Maybe you’ve grown away from them. Just as important as it is to make sure that you’ve named that, you want to let [laughs] the rest of the world know about these individuals.

You might do something like carrying a laminated card in your wallet or your purse, listing the name and the phone number of your healthcare proxy or somebody who can help care for you if something happens to you, something that they can find if there’s an accident or if there’s some sort of a health concern, health crisis.

You would also obviously want to include your primary‑care physician, certain of your medication and your dosages. Again, you don’t want to become an anonymous figure when something bad happens. There’s another document called a POLST, which is a Practitioner Order for Life‑Sustaining Treatment. That’s actually more like a doctor’s order.

You may want that in place in your medical records so that it’s consistent with your living will. It’s basically the prescription for what you’re supposed to do if you have a healthcare crisis and specifically something that’s life‑threatening so people know what care you want.

For other documents, like a financial power of attorney, which has somebody helping you manage your finances if you become incapacitated, you want those things to be held in a place that’s available.

Either you have a relationship with your attorney in a way where they know where all those documents are and then you list on that laminated card to contact your attorney, or you might have a service like a DocuBank or something like that that will hold those documents for you.

Then those services are actually pretty neat because, even though they cost a little bit of money, you’ll get this laminated card. Then it’s a phone number, you punch it in, and it will fax or email you legal documents if they find it. You put it in the right code, and then somebody can have those documents if you need it.

Again, because you don’t have somebody that’s looking in on you, you may want to pay for something like a monitoring service who will monitor your bank and your credit cards for irregular activity and then alert a trusted person if there’s suspicious activity on the record. There’s companies like EverSafe and things like that that will monitor this stuff and then contact whoever you list on there.

Again, it’s another set of safeguards. Remember, what we’re trying to do is build this infrastructure for you as the solo person who won’t have that in family so that you’re not at a disadvantage to somebody that does have a family in terms of getting your legal documents in place.

Then making sure that someone knows how to contact the people, who they are, and someone’s watching over your finances, even if it’s a paid service. Again, these are all things that are there to help you get the same level of protections as somebody with a full‑blown family.

If you are growing older and become a little bit more limited in your capacity about what you can do for day‑to‑day help with your finances, you can hire a daily money manager who can pay bills, balance your checkbook, organize tax papers, and help you with medical claims, things like that.

There are any number of service professionals that might do this. Usually, there’s some form of a social worker or an accredited fiduciary who’s going to be able to do that. Now, in my world, I would probably recommend…

Because I get this paranoid part of my brain that says, “Never give somebody too much power,” I’m probably never going to recommend that you give this daily money manager power of attorney. I don’t think that that’s a great move. You probably want to separate that role out. That way they have some checks and balances.

If you have your lawyer or your financial advisor being in a role who’s looking over your stuff, then you have your financial power of attorney, and then you have your daily money manager, now we have three people who can watch what’s going on with it.

Here in New Jersey, we just got sentencing for an elder‑law attorney out in Ocean County who ended up robbing his clients of three million dollars plus, making himself the fiduciary in all of those roles. Basically, not just like a fiduciary, a responsibility, but naming himself as agent and power of attorney ‑‑ a horrible, horrible set of circumstances.

Because there was only one line between the client and the money, and it was this lawyer, it created the opportunity for there to be exploitation. No matter what you do, you want to have checks and balances in place because you don’t want these people to be able to abuse or exploit you in any position.

It’s not just a lawyer. You hear about these situations where financial power‑of‑attorney agents who are non‑professionals going out and running off with money. You hear about these situations where healthcare aids are basically convincing their senior clients to give them money that they need along the way. We call the undue influence.

These are all situations that are there. [laughs] We want to make sure that we create a structure underneath it that allows us to balance the risk or mitigate the risk because we’ve got these multiple people that are looking on there, looking over you. These situations come up in all kinds of ways. It could be not just a mental capacity. Maybe you’re losing your eyesight.

Again, people who can help you in these roles. You’re going to have to maybe think creatively. Maybe you keep your home, but you rent it out to the people that come in so that there are networks of people that you meet as you grow older. I think the last point is you may need a mind shift as you grow older and you’re a solo senior.

We put so much value on being independent, but, as you grew older, maybe the better skill is to be interdependent. That’s a skill that you need to work on before it’s required. Again, if you’re already in that situation where you need that infrastructure and you haven’t created it, therein lies the risk of essentially being a solo senior.

I hope that this is helpful for you. There are a number of different places that you can look for additional information. There’s Eldercare Locator. It’s a website as a public service by the United States Administration on Aging connecting different people. You can plug in your zip code and see whatever desired service such as caregiver services, legal assistance, or something like that.

I’m always quick to endorse looking through the National Academy of Elder Law Attorneys, what we call NAELA. You go to naela.org. Again, you probably want to be working with a certified elder law attorney because, again, these people have passed an examination and competency in multiple areas of elder care.

Not just on a legal planning side, but housing requirements, insurance, caregiving, and all of those. Village to Village Network, it’s about 200 villages in the US that help people age in place. There’s a few different avenues for you to explore more information. You might want to take a look at those. If you have any more questions on this, feel free to either drop us an email.

If you know somebody who’s a solo senior, go ahead and share this episode with them because this could really help them put a structure in place as they get older that helps them navigate to this road.

That’s it for Make It Last. We’re going to join you again next Saturday with another great show. I hope you enjoyed this one. If you like this show, please go onto iTunes and rate it highly. Go onto the podcast and subscribe. Go to Spotify, catch all the back episodes.

Victor: Other than that, we will catch you next Saturday on Make It Last where we help you keep your legal ducks in a row and your financial nest egg secure. Catch you next time. Bye‑bye.

About Victor Medina

Victor J. Medina, managing attorney of Medina Law Group, devotes his practice to estate planning, helping parents and grandparents to leave their wealth to whom they want, when they want them to have it, and in the way they want.